Workers' Compensation Toolkit

Return to Claims Kit Home

Illinois Compliance



Physician Selection 305/8

Generally, the employee may choose the provider where he or she seeks treatment. The employee's choice of provider will be limited to a selected network of providers if an employer has established what is called a Preferred Provider Program or "PPP." If there is a PPP, the employee has a choice of two physicians from the network within the PPP.

If an employer does not have a PPP, then the employee has a choice of any two providers. This does not include referrals from those two providers. If the injured worker wants to see or be treated by a third doctor, they will be responsible for any medical expenses incurred, unless approved by the Workers' Compensation insurance company.

 

The employee may decline participation in the PPP at any time by sending the employer a written statement. If the employee declines participation, it counts as one of the two choices of medical providers.

If the employee declines participation in the PPP, the employee may choose any doctor or hospital, and go to any doctor to whom the employee is referred by that provider. If the employee wishes to see another chain of providers, however, the employer must approve.

 

First aid and emergency care are not considered to be one of the employee's two choices. Non emergency care obtained before the employee reports the injury to the employer does not count as one of the two choices.

A worker may, without penalty, refuse or limit the involvement of nurses or case managers hired by the employer. The employee is obligated to provide medical records that are relevant to the case, but otherwise a worker's medical care is confidential.